Possum_RN

Sounds like a magnificent place to die. Do you also carry name-brand soda?

well, I'm not a 'seasoned' nurse by any means. But a few thoughts: As a new grad, it's best (if at all possible) to stick around for that first year. From what you say here, it sounds like you are about where a new nurse is expected to be: struggling, but learning. Is it possible to transfer to another unit? Another unit within the same company can offer some 'damage control' for your resume. I would do my very best to keep in touch with those nurses you have built relationships with - just drop them a line on social media every so often. Keep your ears open, network and see who has some insights into good places - maybe even some connections to land you a spot! Especially with maternity leave as an option... well, it does not seem like the best time to quit. Then again, mental health is invaluable, and you have to do what is best for you. Best of luck!

Here's the brochure - http://careers.mission-health.org/wp-content/uploads/sites/6/2017/05/NURS25-reSTART-brochure_V6.pdf

Well, I'm a brand-spanking-new nurse. As I was browsing for new-grad positions, I saw a posting at one of the hospitals that intrigued me: apparently, they have a whole training program for experienced RN's that have never worked in acute care, or who have worked acute previously but worked in subacute for over three years. I thought that was pretty cool!

Ahhh, I remember my first day of CNA clinicals like it was yesterday. I had a resident ask me to help them to the BSC. I got gloves, pulled out the BSC, and the world titled on it's axis because I had the epiphany that "I literally just introduced myself to this human being, and I'm about to stand here while they defecate and then wipe their butt for them. I will then take the bucket of feces, inspect it, and flush it myself". Healthcare is bizzare, man! Things become common as you gain experience, but the fact of the matter is, when you've never been exposed to something it's perfectly acceptable to have no idea what to do - tubes and containers putting stuff in, taking stuff out, measurement devices, charting systems....it's a lot to learn! Ah, I could give you a list of all the stupid things I've done as a CNA/ nursing student / nurse, but it would be a loooong list. Have yourself a chuckle at this experience, learn from it, and forgive yourself. In the future, if you're not sure how to empty or change a device, just ask.

"covered as much as possible" seems like kind of a flimsy policy to me: lots of wiggle room there. Maybe you should cover your tat with a transparent dressing and see what they say? Maybe TWO transparent dressings! I'm nearly 30 - I'm trying to figure out what to get as my first tattoo for my 30th birthday. I'm ALWAYS cold, so covering up my arms is a non-issue for me. Probably as many coworkers have seen my upper arms as have seen my thighs - that is to say, none.

Oh, my goodness....I'm SO sorry you had this experience. Thank you for sharing though: I'm a new hospice RN, and hearing about experiences like this is helpful to me. I would DEFFINATELY speak to the manager, and go up the chain as far as I needed to - pmabraham's suggestions on what to focus on are spot on. It's terrible to me that you've been so soured on Hospice care. I've been so impressed with my employer and the competent, compassionate care I've seen provided...it does not strike me as a cash-grab at all, and I'm very proud of what we do. Recently, I had a patient whose scheduled Morphine and Ativan were no longer adequately controlling his symptoms. We exhausted his PRN doses too. The nurse who was training me explained that I needed to call the in-house doctor to adjust doses, and I was told "he might seem short if you call him at 3am, but do it anyways....you won't see him actually ANGRY unless he hears you let a patient suffer without advocating for them. Don't ever let that happen".

Yeah, as soon as I saw C, I was like "thats it!", but not because I would actually do that in real life....only because I just passed nursing school and know how to answer nursing questions. Answering nursing-school-questions is just one of those skills you have to pick up to survive, as frustrating as it is. As others have pointed out, C is the closest to an assessment/ data-gathering response. I had a question in OB/Peds that still haunts me to this day. The gist of it was that a mother and neonate arrive to the small regional hospital where you work via ambulance, the baby was born in transit. Upon assessment, the nurse realizes that the neonate has "multiple congenital abnormalities". What do you do? According to my program director (who wrote the question, despite teaching not a single class at that point in the program), you separate the mother and infant; admit the mother, send the baby to the closest large hospital with a NICU. I answered that you admit the mother and neonate....my reasoning being that the baby needed to be properly assessed before transport anyways...what were the "congenital abnormalities" anyways? I assumed we HAD a NICU...the "small regional hospital" where I actually worked in real life had one, after all. But apparently I was to assume (for once) that this was not perfect-nursing-world. Bear in mind we did not learn anything about pre-transfer stabilization and preparation until two semesters later in Med/Surg II...... Anyways, I mean to convey my total empathy for dealing with terribly-written nursing questions. I'll be muttering angrily about that neonate and mother in the ambulance when I'm in the nursing home one day

Just another lil' insight: I studied with and was very close to the valedictorian in my class. I made C's, she made A's with a B or two. I had lunch with her last week - turns out, we're making the same exact base pay! I'm SURE it looked good on her resumes and was commented on in her letters of recommendation... Certainly, having A averages when finals came around would have reduced my stress level at end-of-semester. But, at the end of the day, we're all doing all right!

Man....this is so bizarre to me! I am a new RN (also graduated in May), and I applied to four places. I got offered positions at two, and then after I'd accepted the second, got call backs from the other two for interviews! I did not have many shiny accolades or accomplishments to pad my resume - but I did have a stable job history as a CNA. However, I live in the rural South. Networking with classmates and other links you made in your program may be of help - but is it at all possible to move temporarily out of the city, into a more rural area close by? You might want to change your focus from simply churning out sheer amounts of applications, to re-connecting with old contacts and targeting locations where you know someone and asking them to put in a good word for you. At least in my area, referral bonuses are common. I knew someone at the company where I now work, and they were VERY eager to put in a good word, since it'll put some money in their pocket once I've been there a year. If not, you may need to refocus your energy into relocation - I know it's not ideal, but it's better than working full-time job-hunting with nothing to show for it. Best of luck!

Are there other med aides, or a nurse you trust, or (better yet) a policy manual you can consult? I know as a nurse at my facility, its insufficient to say "the patient reports feeling better" for a PRN pain med - there has to be a before/after numerical pain assessment, either the 1-10 patient-reported one, or a FLACC score (if, say, they are asleep when you re-assess, or are non-verbal). For a PRN anxiety med, for example, they will accept a patient's report, or an entry like "PRN anxiolytic medication effective, as evidenced by decreased muscular rigidity and return of deep, unlabored breaths". These strike me as very "nurse-y" assessments. But I have not worked with med aides since I was a CNAI, so I'm unfamiliar with their scope of practice. Best to consult someone familiar with your facilities policies.

My favorite brand of scrubs is Dickies, because they last FOREVER - very good stitching. I also like Purple Label by Healing Hands, just for the fit (I'm 5'1, 115 lbs, so most scrubs hang on me and drag the floor). I love my Klogs shoes. I also wear Merrell Jungle Moc's . -very light with good support. But these things will very much be up to personal preference - going to your local uniform store and trying on some different things (even if you later order them online) will be most helpful. I order compression hose from Amazon - SB sox are pricy, but mine have lasted for years without loosing their compression. I loveee them! I have the Littmann Lightweight II S.E. stethoscope - it runs about $60. It works very well for general nursing assessments. I've tested it against other brands, and it picks up more sounds than the cheaper ones I've tried....though most any cheapo-stethoscope will do for a BP or simple auscultation.

I'm sorry that you had this experience, I know it's frustrating. While I agree with other commenters that, as a 'fresh' CNA, it was probably not advisable to comment on the quality of experienced staff's work... I've seen bad facilities too (as a CNA). I know it's really distressing. It's great to be a patient advocate, but reacting in anger and being confrontational rarely changes another's behavior. On one hand, the last time I performed, say, a bed-to-chair one-person assist CNA-school-correct, was probably about one week after I got my first job. On the other hand, I insisted on doing Hoyer lifts with a spotter, pretty much verbatim like school taught me. The LTC facility I worked at had the staffing ratio to allow me this, although I gained a reputation as a "slow" worker. As a nurse, there are short-cuts I do as well, but for instance, I WILL NOT draw up two different patient's meds at the same time - a common short-cut you will see some nurses doing. The fact is that some short-cuts are necessary, but you HAVE to use critical reasoning skills to assess the risks. Have you considered going into hospice? I now work on an in-patient hospice unit. Usually it's one nurse and one CNA per 5 residents. This week, we had 4 patients in the facility. Because of the acuity of the patients, we had a nurse and a CNA per two patient's - technically, they could have sent one CNA and one nurse home, but they really do their best to allow you to focus on compassionate care for each patient you will be assigned. In your example of the patient who was roughly turned with a hip fracture....that breaks my heart. If it were my patient, I'd have directed the CNA's to wait to change them until I had given them their pain meds (I have the full blessing to call the Hospice Physician if I need to order a one-time dose of pain meds if they have nothing available). Then I probably would have had the time to go in with them, and help them stabilize the fractured extremity while we turned them (never completely to that side). I'm not saying it still would not have hurt, but we support one another and the patient! Different fields of nursing and even different facilities within the same field have different cultures of care. I hope this frustrating experience has at least been one you can learn from. Home care, Hospice, and private LTC's tend to have more focus on the patient as an individual, if that's what you're looking for. I'm sure there are other opportunities as well. Best of luck!

Let me start out by saying that I recognize you from around the forum. I always read your responses when I see your avatar and generally agree with you - I admire your attitude. However (Ah, forgive me!), you concede that a mentally ill patient will need lots of attention, and will potentially need pharmacological interventions to de-escalate. I really responded to the OP, because, in the population of my local hospital's med/surg unit (where I was a CNA), we dealt with A LOT of drug addiction - diagnosed and un-diagnosed in patients, lots of patient's visitors, etc. Twice, I had tables kicked into me. Once, I was bodily cornered and threatened in a patient's room. I was groped too many times to count. Hearing comments like yours.....well, it is hurtful, though I KNOW that you do not intend it as such. I took the Crisis Prevention Intervention classes every year. I did (and do) pride myself on my interpersonal communication: I had many patients I was told were difficult, who I got along great with. I did the online learning multiple times. I know Im not supposed to let myself get cornered in a room, I know what they taught me about "When you...Then we can..." statements, etc. But, when we were trying to monitor and respond to a full load of patient's physiological conditions....it's really hard to keep up with the large subset that also needs EXTENSIVE psychological support as well. Being frustrated with the lack of support and overwhelming need is OKAY. I've left med-surg, but I just saw a facebook post from the sweetest nurse I knew there - broken ribs, from a patient. The danger is REAL, and being told that we simply are not doing our jobs properly is very hurtful. We all know that certain responses have a better chance of de-escalating situations. We all know Nurse Ratchett is out there... but can we also agree that something is truly rotten in the state of healthcare, when nurses are the victims of so much violence and abuse (both mental and physical), and are so poorly supported?

"C's make degrees!" Even doctors have an equivalent saying: "C=M.D." one of my friends has a T-shirt that says "75% - that means I know 3 out of 4 diseases, so the odds are good!" I was always a solid A student. Squeaked though nursing with C's, but I was also dealing with some routine life crises, as one does. And 40% of the class I began Nursing 101 with failed out before the end, so.....I just can't hate myself for that. As long as you are retaining information, don't get too caught up in your letter grades. Aim high, but forgive yourself (and others), if you don't attain your normal.